The role of Interleukin-12 in immune-mediated rheumatic diseases

Objective: IL-12 is a proinflammatory cytokine produced by different antigen presenting cells. It has been shown to exert a critical role in inducing Th1 phenotype, thus initiating cell-mediated immune responses, but the significance of IL-12 in rheumatic diseases is not clear. Aim of the study was to determine IL-12 serum levels in immune rheumatic diseases and to analyse the relationship of this cytokine with main clinical and laboratory parameters. Methods: we analysed, by ELISA, serum IL-12 levels in 114 patients with SLE, 47 with SS, 32 with SSc, 84 with RA, 138 with PA and in 17 healthy controls. We also examined main clinical and laboratory parameters, including autoantibody profile and clinical indices of disease activity. Results: IL-12 serum levels were significantly higher in SLE and SS patients respect to controls. IL-12 serum levels were significantly higher in SLE patients compared to those affected by RA, PA and SSc. When we evaluated disease activity in SLE patients, we found significantly higher IL-12 serum levels in subjects with fever or in those without renal involvement, while no correlation was found in the other rheumatic immune diseases. Conclusions: these findings suggest that IL-12, modulating cell and humoral immune responses, is involved in the pathogenesis of immune rheumatic diseases, such as SLE and SS

Mother-to-child transmission of human immunodeficiency virus in aten years period

<p>Abstract</p> <p>Objectives</p> <p>to evaluate mother-to-child transmission (MTCT) rates and related factors in HIV-infected pregnant women from a tertiary hospital between 2000 and 2009.</p> <p>Subjects and method</p> <p>cohort of 452 HIV-infected pregnant women and their newborns. Data was collected from recorded files and undiagnosed children were enrolled for investigation. Statistical analysis: qui-square test, Fisher exact test, Student <it>t </it>test, Mann-Whitney test, ANOVA, risk ratio and confidence intervals.</p> <p>Results</p> <p>MTCT occurred in 3.74%. The study population displayed a mean age of 27 years; 86.5% were found to have acquired HIV through sexual contact; 55% were aware of the diagnosis prior to the pregnancy; 62% were not using HAART. Mean CD4 cell-count was 474 cells/ml and 70.3% had undetectable viral loads in the third trimester. HAART included nevirapine in 35% of cases and protease inhibitors in 55%; Zidovudine monotherapy was used in 7.3%. Mean gestational age at delivery was 37.2 weeks and in 92% by caesarian section; 97.2% received intravenous zidovudine. Use of AZT to newborn occurred in 100% of them. Factors identified as associated to MTCT were: low CD4 cell counts, elevated viral loads, maternal AIDS, shorter periods receiving HAART, other conditions (anemia, IUGR (intra uterine growth restriction), oligohydramnium), coinfecctions (CMV and toxoplasmosis) and the occurrence of labor. Use of HAART for longer periods, caesarian and oral zidovudine for the newborns were associated with a decreased risk. Poor adhesion to treatment was present in 13 of the 15 cases of transmission; in 7, coinfecctions were diagnosed (CMV and toxoplasmosis).</p> <p>Conclusion</p> <p>Use of HAART and caesarian delivery are protective factors for mother-to-child transmission of HIV. Maternal coinfecctions and other conditions were risk factors for MTCT.</p

Allergic sensitization to common pets (cats/dogs) according to different possible modalities of exposure: an Italian Multicenter Study

Background: The query "are there animals at home?" is usually administered for collecting information on anamnesis. This modality to consider exposure to pet allergens constitutes a potential bias in epidemiological studies and in clinical practice. The aim of our study was to evaluate/quantify different modalities of exposure to cat/dog in inducing allergic sensitization. Methods: Thirty Italian Allergy units participated in this study. Each centre was required to collect the data of at least 20 consecutive outpatients sensitized to cat/dog allergens. A standardized form reported all demographic data and a particular attention was paid in relieving possible modalities of exposure to cat/dog. Results: A total 723 patients sensitized to cat/dog were recorded, 359 (49.65%) reported direct pet contact, 213 patients (29.46%) were pet owners, and 146 subjects (20.19%) were exposed to pets in other settings. Other patients were sensitized by previous pet ownership (150-20.75%) or indirect contact (103-14.25%), in 111 subjects (15.35%) any contact was reported. Conclusions: Only 213 patients (29.46%) would be classified as "exposed to animals" and 510 (70.54%) as "not exposed" according to usual query. Our classification has shown that many "not-exposed" subjects (399-55.19%) were "really exposed". The magnitude of exposure to pet allergens at home is not related exclusively to pet ownership. These considerations should be taken into account during the planning of epidemiological studies and in clinical practice for the management of pet allergic individuals

MULTIPLE CERVICAL CORD COMPRESSIONS IN PSORIATIC-ARTHRITIS

Coexistent atlantoaxial subluxation (AAS) and subaxial spondylitic changes led to multiple cervical cord compressions in a psoriatic arthritis (PA) patient. Magnetic resonance imaging and myelography were unable to define exactly which cervical lesion was responsible for neurological symptoms. After surgical intervention for the worsening of bulbar symptoms, clinical course of neurological complaints suggested that neurological involvement was due only to anterior/vertical AAS

Psoriatic polyarthritis of the elderly: radiological assessment

The authors examined retrospectively 157 patients with psoriatic polyarthritis and found in 9 cases (5.7%) a late onset (≤60 yrs) of the articular involvement. The radiological features of these patients were compared with those of 32 subjects presenting an earlier onset (20-45 yrs) but a comparable disease duration, to point out any relevant differences due to the age of onset. The late onset psoriatic arthritis is characterized by a more frequent involvement of DIP (p &lt; 0.01) and PIP-MCP (p &lt; 0.04) joints. In patients with late onset polyarthritis the mean number of DIP (p &lt; 0.01), PIP-MCP (p &lt; 0.004) and DIP-PIP-MCP (p &lt; 0.01) joint erosions, the mean degree of carpal involvement (p &lt; 0.04) and the number of proximal limb joints with radiological lesions (p &lt; 0.03) are significantly higher. Moreover 44% of elderly onset patients have a severe radiological axial involvement. The evidence of severe radiological joint lesions in late onset psoriatic polyarthritis suggests that a careful radiological assessment is required for a better prognostic and therapeutic evaluation of the disease

Red blood cell methotrexate levels in rheumatoid arthritis: Correlations with changes of class specific circulating rheumatoid factors

Red blood cell (RBC) methotrexate (MTX) levels have been studied in rheumatoid arthritis (RA) in attempt to correlate them with efficacy or toxicity, but the relationship with humoral immune system has not been analyzed. We determined the RBC concentrations of MTX in 27 RA patients treated with low-dose MTX and we studied the correlations with changes of immunological, clinical and biological parameters from baseline. After 12 months of therapy, erytrocyte MTX levels, ranging fram 20 to 248 nM/l (m ± sd = 50 ± 58 nM/l), varied considerably among patients and were significantly correlated only with changes from baseline of IgA-RF (p &lt; 0.05). Changes of clinical and biological parameters from baseline were not correlated with MTX levels of RBC and the lowering of IgA-RF during the treatment. Thus we believe that the meaning of this correlation between erytrocyte MTX levels and changes of IgA-RF is unclear and does not seem clinically relevant

Vertebral hydatid disease after extramedullary intraspinal localization. A case report

A case of echinococcosis in the retroperitoneal space, spine and bones, studied by computerized tomography (CT), magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) is reported. The extramedullary spinal parasitosis was revealed and surgically removed by right D12 laminectomy. After three years the imaging follow-up showed the parasitic involvement of the same vertebral body, suggesting their iatrogenic origin